NHS CAMPAIGN GROUP’S OPEN LETTER TO WALTHAM FOREST MPs

To: Stella Creasy MP
John Cryer MP
Iain Duncan Smith MP

We, as members of Waltham Forest Save Our NHS, are shocked by the latest CQC report on Whipps Cross Hospital. We call on you, our elected representatives to address the impossible financial position in which Whipps now sits. We ask you to address Barts’ private finance initiative (PFI)and work together to remove this debt burden which threatens the continued existence of our local hospital.

Our much loved hospital has been tragically destabilised; it is a victim of both the destructive effects of the Health and Social Care Act (HSCA) and of under-funding. These problems need dealing with at a national level. However, there is one overriding factor behind this crisis which you can help to resolve by working together now: the PFI deals that weigh so heavily on Barts Health Trust (Barts). PFI contributed to Barts’ deficit leaping to £93M in recent months. The PFI costs are unmanageable, unreasonable and growing!

We urge you not to use our NHS for political point-scoring and to work to start resolving the problems that face Waltham Forest’s NHS services. We are confident that other borough residents will wish to join us in this call. Barts is England’s largest hospital trust, has the country’s biggest PFI and its deepest deficit. PFI allows government to keep building costs off its balance sheet and allows business to make profit without risk. None of this is good news for Waltham Forest’s residents.

Barts spends over £2M a week for its PFI deals, an unaffordable amount, far in excess of market rates. Government funding for NHS building projects would have offered much better value. Both Labour and Conservatives have promoted PFI use over the past 20 years. All NHS hospitals are inadequately funded; faced with under-funding, disintegration caused by HSCA and the exorbitant PFI costs, Barts chose to make £58M of cuts last year.

In a vain attempt to save money, Barts management enforced mass redundancies and a demoralising down-banding of staff, which led to the disastrous consequences detailed in the CQC report. Bullying of staff and attempted cost savings resulted in an exodus of experienced skilled staff, low morale, an inability to maintain staffing levels, and a doubling of agency costs, all of which could only have a detrimental impact on patient safety. To add insult to injury, Barts paid millions to private consultants for ‘advice’ rather than listen to its staff.

PFI contracts cause our hospitals to outsource key services even when outsourcing is the more expensive option. Barts Health saved £4M per year by bringing some of the services previously provided under the PFI back in-house. A broader cost-saving exercise must now be implemented, bringing outsourced services in-house across the whole Trust.

East London suffers significant levels of poverty and deprivation, factors that lead to ill health. Funding must be increased and services created that will meet the needs of East London’s growing population. Instead, local health services have been told to make an 11% cut over the next five years. It is clear that services are being sacrificed on the altar of PFI and that PFI costs must be annulled to safeguard the health of the local community. Arguably there is no greater issue affecting the welfare of your constituents. Faced with a perfect storm of HSCA, under-funding and PFI, Barts management cannot see off the PFI problem on its own. As our elected representatives it is incumbent upon each of you to work together to restore NHS services to your constituents, the people who pay not only for the NHS, but for you to properly represent our interests.

We call on you to put aside your political differences and work with Barts and the PFI companies to get rid of the onerous burden of PFI costs. We can then start to restore order at the borough’s much-needed hospital, Whipps Cross and improve health services across Waltham Forest.

Evidently with the general election looming, time is of the essence. We look forward to your response.

As members of our campaign attend many meetings, ask many questions and get many answers we thought that the answers should be publicly available. Here are the questions and answers from 5 November.

1. There are reports in the media about Carillion that are of concern: in September 2014 at their Board Meeting, Great Western Hospital recorded a lack of confidence in Carillion following a Food Standards Agency inspection that found food badly stored, out of date, and uncovered in freezers. Carillion has been in dispute with staff at the hospital over working practices since 2011. It’s also reported that there are long-standing staff complaints about bullying and racism. More than fifty staff are allegedly taking Carillion to Employment Tribunal, and it is reported that there was an investigation at a Carillion Surgicare Centre in 2013 following 3 deaths. Can the Board inform us which of the Trust’s services are run by Carillion? How many Trust staff monitor those services and how do they do this? What steps has the Board put in place to satisfy itself that Carillion is not putting patients at risk or mistreating its staff?

The Director of Strategy explained that Carillion currently provided the following services at The Royal London and Barts sites: catering, security, reception, cleaning, portering, pest control and helpdesk. They would be providing the same portfolio of services from 1 December 2014 at Whipps Cross and from 1 January 2015 at Mile End. In addition, Carillion would be providing security and reception services at Newham from 1 December 2014. The Trust had a team of six staff monitoring Soft FM services through a range of formal and informal mechanisms including ward and department visits, performance information and face-to-face liaison meetings. The Trust was not aware of any concerns to suggest that there was a problem of staff being mistreated but the opportunity would be taken to discuss the issues raised with Carillion.

2. It has been recently reported that Barts has spent nearly £1m in 10 months on its turnaround consultant. Given the number of staff who have been down-banded, how would Barts justify such costs to staff who work hard on the frontline and have seen their own pay cut? What specific outcomes were required of the consultant to justify the expenditure?

The Chief Executive explained that the Trust was tracking delivery of a £70 million cost improvement programme in the current year in addition to flow through of £19 million from 2013/14, delivering an overall improvement in financial performance of £89 million. This represented a very significant year- on-year improvement which provided the context for the turnaround expenditure described.

3. The Barts Health annual accounts for 2013/14 show a £20.5m spend on consultants. What were these costs for? Which organisations have provided consultants? What specific outcomes were required to justify the expenditure?

The Chief Financial Officer explained that consultancy costs in the annual accounts included a range of expenditure on management consultancy, project management, legal and procurement advice, business case support, etc. The Trust had engaged with over 300 firms in the previous year, the largest being PricewaterhouseCoopers LLP as part of the turnaround programme. Monthly expenditure information was available on the Trust website.